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House of Lords

Wednesday, 22nd October 2003.

The House met at half-past two of the clock: The LORD CHANCELLOR on the Woolsack.

Prayers—Read by the Lord Bishop of Sheffield.

NHS Hospital Treatment: Overseas Visitors

Baroness Boothroyd asked Her Majesty's Government:

    What action is being taken to recover the amount owing to the National Health Service by overseas visitors, known as National Health Service tourists, who have unlawfully obtained free medical treatment.

The Parliamentary Under-Secretary of State, Department of Health (Lord Warner): My Lords, the National Health Service (Charges to Overseas Visitors) Regulations 1989 place a duty on NHS trusts to establish whether a patient is eligible for free NHS hospital treatment and, if not, to levy a charge for any treatment provided. The Government are consulting on proposals to strengthen the charging regulations.

Baroness Boothroyd: My Lords, is the Minister aware of the concern in the National Health Service at the amount owed to it by illegal overseas patients? Can he give an indication of that debt and say how much has been recovered by overseas patient officers and debt collectors? Am I to understand that we can look forward to new regulations that may well be brought in to help to tighten up what can only be described as exploitation of the National Health Service?

Lord Warner: My Lords, under this and the previous government, it has been down to local hospitals to collect charges in accordance with the regulations. We do not collect information on the issue at the centre. As the House knows, devolution is the world that we live in, and we do not want to increase bureaucratic demands on the frontline National Health Service.

In 2001–02, 1.2 million was written off by local health trusts for uncollected debts in the area. However, it is not possible to qualify the total costs that may be lost.

Baroness Thomas of Walliswood: My Lords, as a former member of a hospital trust board, I am astonished that that important information is not among the millions of pieces of information that the board must yield to the central authorities. How did that oversight occur? Do the Government intend to use a future policy on identity cards to check whether

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people are liable to pay for healthcare? If so, what sort of identity card are we talking about—the Home Secretary's or the Foreign Secretary's?

Lord Warner: My Lords, as the noble Baroness knows, the Cabinet is still discussing the matter. It would be wrong to pre-empt the outcome of that discussion.

Earl Howe: My Lords, what methods are currently in place in the NHS for checking someone's entitlement to free NHS services?

Lord Warner: My Lords, where there are concerns about whether someone is required to pay charges in those circumstances, the usual arrangement is that an overseas visitor manager will arbitrate, taking account of the requirements in the charging regulations.

Lord Rotherwick: My Lords, who decides whether there is such a concern about someone who comes to a hospital? Surely, that is a difficult task, since some overseas visitors speak extremely good English. Who is responsible for deciding whether a person should have healthcare?

Lord Warner: My Lords, as I thought I made clear, under the charging regulations it is down to the local hospital. I have explained the local system to the noble Earl.

Lord Mackie of Benshie: My Lords, how much money do we owe French and other authorities for treatment in those countries?

Lord Warner: My Lords, I have no idea, but I will be happy to inquire and to write to the noble Lord.

Lord Walton of Detchant: My Lords, does the noble Lord agree that, if overseas visitors come to this country without any intention of seeking medical care but happen to fall ill during their visit, they are entitled to the services of the National Health Service? We are referring to those who come specifically for medical treatment and who must carry the cost of that treatment.

Lord Warner: My Lords, I am grateful to the noble Lord for expressing that point of view. We have made clear all along to the NHS that urgent treatment needed to save life or to prevent a condition becoming immediately life-threatening should not be withheld. The NHS remains a humanitarian service.

Carbon Management Strategy

2.41 p.m.

Lord Ezra asked Her Majesty's Government:

    Whether they consider that the United Kingdom should develop a long-term carbon management strategy, including fossil fuels, as recommended in

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    the report of the Department of Trade and Industry technology service mission to the United States and Canada.

The Parliamentary Under-Secretary of State, Department of Trade and Industry (Lord Sainsbury of Turville): My Lords, the Government's energy White Paper provides a long-term strategy for the reduction of carbon emissions in line with the recommendation of the Royal Commission on Environmental Protection for a 60 per cent reduction by 2050. Fossil fuels are recognised as an important part of the energy mix in the strategy. My department is currently considering the development of a carbon abatement technologies programme for fossil fuel power generation. We will develop that new programme with the full involvement of UK industry.

Lord Ezra: My Lords, I thank the noble Lord for that fairly encouraging response. Nevertheless, has the Government's record so far in carrying out a carbon management strategy not been somewhat patchy? They have given substantial support to certain renewables, notably wind power, but less support to other means of dealing with carbon emissions, such as the recovery and treatment of methane from coal mines, combined heat and power including micropower, in which I declare an interest, and clean coal technology with carbon extraction.

Is the noble Lord aware that, according to the mission's report, in North America, the clean use of fossil fuels, notably coal, is regarded as a key component in developing a sustainable energy future, and a number of clean coal technology plants already operate or are under construction there? When can we expect such plants to operate in the UK?

Lord Sainsbury of Turville: My Lords, we have what is, in effect, a carbon management strategy with different parts. Part deals with the renewables obligation and other parts are appropriately best dealt with by research. Research is taking place on areas such as carbon capture and storage, renewables and, as I said, we are developing a carbon abatement technologies strategy that will cover such things as carbon capture and storage, co-firing of fossil fuel with biomass and higher power plant efficiency.

Earl Attlee: My Lords, clearly we must have a carbon management strategy for the long term. The Minister appears to be satisfied with his own strategy, but what about that of China and other developing nations?

Lord Sainsbury of Turville: My Lords, I was recently in China discussing this matter. This is a huge opportunity for British industry, which has good experience of clean coal technology, to sell into a huge market that is now very keen to deal with its environmental problems. China is keen to get clean coal technology because of its large quantities of coal.

Lord Campbell of Croy: My Lords, in the past, nature has provided the necessary balance between the amounts

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of carbon dioxide entering the atmosphere and being taken out of it. Are not today's practices upsetting that balance, especially in industrial and urban areas?

Lord Sainsbury of Turville: My Lords, that is clearly the case. That is why the energy White Paper went into the question of dealing with the problems of climate change in such length. We have a major programme to increase renewables precisely to deal with this type of problem.

Viscount Ullswater: My Lords, the Government have an aspirational target of 20 per cent of energy to be produced by renewables by 2020. Will the Minister recognise that, by that time, all but one of the nuclear power stations will have closed, so the net gain will be nil?

Lord Sainsbury of Turville: My Lords, the nuclear plants last slightly longer than that, but we have already said that we will keep the nuclear option open in case we cannot, by the means that we have set out, achieve the targets that we believe to be very important.

Baroness Sharp of Guildford: My Lords, this country used to be at the leading edge of clean coal technology. What has happened to the research programme on that technology? Has it been maintained?

Lord Sainsbury of Turville: My Lords, the clean coal technology programme has been maintained. There will be another call this year for programmes within that framework so that we continue to maintain our position in that technology.

Lord Woolmer of Leeds: My Lords, the noble Lord, Lord Ezra, mentioned the work on clean coal technology in the United States. Is not one of the problems that arose with nuclear energy that we engaged in too many types of nuclear plant instead of learning from existing proven technologies? Why are we not doing more research in this area? Why are we not using clean coal technologies that have been developed in the United States to make quicker progress?

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